Healthcare Provider Details

I. General information

NPI: 1881021764
Provider Name (Legal Business Name): ALEXANDER JOVANNI GARRIDO PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2013
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 1ST ST STE 2000
ANKENY IA
50021-2077
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-7555
  • Fax: 515-643-7560
Mailing address:
  • Phone: 515-643-7555
  • Fax: 515-643-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011205
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12389
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP015867T
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: